[PDF] Antenatal screening – the first and second trimester

pregnancy with Down syndrome, women with a This involves a blood test between 14 weeks and 20 weeks during the first trimester of pregnancy Second

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[PDF] Antenatal screening – the first and second trimester - RACGP

pregnancy with Down syndrome, women with a This involves a blood test between 14 weeks and 20 weeks during the first trimester of pregnancy Second

Leonard Bonacquisto

Antenatal screening

The first and second trimesterWho should have antenatal screening?

Antenatal screening should be

discussed with all pregnant women so that they can make an informed decision whether to proceed with testing. In

Victoria, 80% of pregnant women have

an antenatal screening test. There are no specific contraindications or precautions.

Women must understand that the test is a risk

assessment and places their pregnancy in an increased or decreased risk category. Women must also understand that if the test suggests a high risk they will be offered a diagnostic test that carries a small risk of miscarriage. Some women (eg. those who have had a previous pregnancy with Down syndrome, women with a family history of neural tube defects and women over 35 years of age) may choose to proceed directly to a definitive diagnostic test. Women carrying twins can still have screening, but women carrying higher order multiples cannot be offered antenatal screening.What does screening involve?

First trimester screening

This involves a nonfasting blood test at the

woman's tenth week of pregnancy (range 9 weeks to 13 weeks and 6 days) and an obstetric ultrasound at the woman's twelfth week (range

11 weeks and 1 day to 13 weeks and 6 days). The

ultrasound should be completed at an accredited centre by a clinician with specific training. Second trimester screening

This involves a blood test between 14 weeks

and 20 weeks and 6 days. For either blood test, a 7 mL of blood is required in a plain vial with no anticoagulant. The blood can be drawn at any major pathology blood collection centre and is then delivered to the appropriate laboratory with an accompanying specific request form.

How do I arrange antenatal

screening?

For first trimester screening, women require

two separate forms - one for the ultrasound and one for the blood test. For second trimester screening they only require a blood test form.

Although the blood sample can be taken at

the same time, the blood tests should not be ordered on the standard blood test pathology slip as very specific information is required.

Check with your local providers and ensure you

have the correct forms. Ensure you complete all the information as many of these variables are used to calculate the pregnancy specific risk.

Key information for the 10 week blood specimen

includes: the patient's date of birth, her weight, her ethnicity, if she has diabetes, the date of her last normal menstrual period, her estimated date of delivery, and if any previous pregnancies have been affected by Down syndrome. Also indicate if this is a twin pregnancy, if the pregnancy was

achieved via IVF and, if an egg donor was used, Antenatal screening is performed in the first or second trimester to determine

whether a pregnant woman's baby has an increased risk of having Down syndrome (a chromosomal abnormality affecting one in 500 pregnancies), Edward syndrome (one in 3000) or open neural tube defects (one in 750). First trimester screening combines results from a blood test with a nuchal translucency and nasal bone obstetric scan during the first trimester of pregnancy. Second trimester screening requires only a blood test. The screening approach varies across Australia; this article primarily describes the Victorian protocol.

Keywords:

mass screening; preventive medicineThis article forms part of our 'Tests and results' series for 2011 which aims to provide information

about common tests that general practitioners order regularly. It considers areas such as indications,

what to tell the patient, what the test can and cannot tell you, and int erpretation of results.

Reprinted from

STRALIA

FAmILy PhySICIAn VoL. 40, no. 10, oCTobER 2011

Antenatal screening - the first and second trimester the age of the donor (if known.) The patient then needs to attend for the blood test within the

10 week 'window' and book for the obstetric

ultrasound within the 12 week 'window'. If there is uncertainty about the last normal period, a dating ultrasound scan is required to allow accurate planning.

What do I tell the patient?

Detailed explanation of antenatal screening

is required so that women understand that screening only tests for certain chromosomalquotesdbs_dbs7.pdfusesText_5

[PDF] [PDF] Antenatal screening – the first and second trimester - RACGP

[PDF] Bleeding in the 2nd trimester pregnancy (12-19+6 weeks)